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Calorie Postings Don’t Change Habits, Study Finds

A study of New York City’s pioneering law on posting calories in restaurant chains suggests that when it comes to deciding what to order, people’s stomachs are more powerful than their brains.

The study, by several professors at New York University and Yale, tracked customers at four fast-food chains — McDonald’s, Wendy’s, Burger King and Kentucky Fried Chicken — in poor neighborhoods of New York City where there are high rates of obesity.

It found that about half the customers noticed the calorie counts, which were prominently posted on menu boards. About 28 percent of those who noticed them said the information had influenced their ordering, and 9 out of 10 of those said they had made healthier choices as a result.

But when the researchers checked receipts afterward, they found that people had, in fact, ordered slightly more calories than the typical customer had before the labeling law went into effect, in July 2008.

The findings, to be published Tuesday in the online version of the journal Health Affairs come amid the spreading popularity of calorie-counting proposals as a way to improve public health across the country.

“I think it does show us that labels are not enough,” Brian Elbel, an assistant professor at the New York University School of Medicine and the lead author of the study, said in an interview.

New York City was the first place in the country to require calorie posting, making it a test case for other jurisdictions. Since then, California, Seattle and other places have instituted similar rules.

Calorie posting has even entered the national health care reform debate, with a proposal in the Senate to require calorie counts on menus and menu boards in chain restaurants.

This study focused primarily on poor black and Hispanic fast-food customers in the South Bronx, central Brooklyn, Harlem, Washington Heights and the Rockaways in Queens, and used a similar population in Newark, which does not have a calorie posting law, as a control group. The locations were chosen because of a high proportion of obesity and diabetes among poor minority populations.

The researchers collected about 1,100 receipts, two weeks before the calorie posting law took effect and four weeks after. Customers were paid $2 each to hand over their receipts.

For customers in New York City, orders had a mean of 846 calories after the labeling law took effect. Before the law took effect, it was 825 calories. In Newark, customers ordered about 825 calories before and after.

On Monday, customers at the McDonald’s on 125th Street near St. Nicholas Avenue provided anecdotal support for the findings.

Photo

April Matos, 24, bought a Happy Meal at a McDonalds for her 3-year-old son, Amari, and a Snack Wrap for herself. Life is short, she said. I started eating everything now Im pregnant.Credit
Hiroko Masuike for The New York Times

William Mitchell, from Rosedale, Queens, who was in Harlem for a job interview, ordered two cheeseburgers, about 600 calories total, for $2.

April Matos, a 24-year-old family specialist, bought her 3-year-old son, Amari, a Happy Meal with chicken McNuggets, along with a Snack Wrap for herself. She said with a shrug that she had no interest in counting calories. “Life is short,” she said, adding that she used to be a light eater. “I started eating everything now I’m pregnant.”

Nutrition and public health experts said the findings showed how hard it was to change behavior, but they said it was not a reason to abandon calorie posting.

One advocate of calorie posting suggested that low-income people were more interested in price than calories.

“Nutrition is not the top concern of low-income people, who are probably the least amenable to calorie labeling,” said Michael F. Jacobson, executive director of the Center for Science in the Public Interest, a nonprofit health advocacy group in Washington.

New York City health officials said that because the study was conducted immediately after the law took effect, it might not have captured changes in people’s behavior that have taken hold more gradually.

A year ago, officials pointed out, the city began an advertising campaign telling subway riders that most adults should eat about 2,000 calories a day, which might put the calorie counts in context.

While the N.Y.U. study examined 1,100 restaurant receipts, the city is doing its own analysis of 12,000 restaurant receipts, which it plans to release in a few months, said Cathy Nonas, director of nutrition programs for the City Department of Health and Mental Hygiene.

People sometimes confuse intentions with actions, said Marie Roth, a registered dietitian with Blythedale Children’s Hospital in Valhalla, N.Y.

“Just by contemplating healthier choices, they feel like they could have done it and maybe they will the next time,” Ms. Roth said.

Jonathan Allen contributed reporting.

A version of this article appears in print on October 6, 2009, on page A26 of the New York edition with the headline: Study Finds Calorie Postings in Restaurants Don’t Change Eating Habits. Order Reprints|Today's Paper|Subscribe